Abstract
More New Zealanders are forecast to grow older in the community, ranging in levels of abilities and needs. Many health conditions can affect swallowing function or nutrition status in older age. However, older adults may not be aware of risk factors and when to seek help. A nationwide survey was conducted of self-reported swallowing ability and nutrition status in community-living New Zealanders aged 65 years and older to assess whether undisclosed swallowing and nutrition problems exist. Respondents completed an amalgamated questionnaire including two validated screening tools: Eating Assessment Tool (EAT-10) and Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN-II). A convenience sample of 1020 adults aged 65–96 years old was obtained. Mean EAT-10 score was 2.15 (SD = 4.3); 22.1% scored above the normative score (3 or more). Mean SCREEN-II score was 48.50 (SD = 6.5); 46.9% scored below normal (< 50 for adults under 85 years old, < 49 for adults over 84 years old). EAT-10 scores significantly correlated with SCREEN-II scores (p < 0.001). Scores did not correlate with age or differ between age groups. Significantly more respondents with medical history associated with dysphagia disclosed swallowing and nutrition problems (p < 0.001). This data suggest increased prevalence of swallowing difficulties in older age is attributed to health conditions and medications, rather than ageing itself. Swallowing complaints from community-living older adults should not be ignored or attributed to the normal ageing process. This study supports routine nutrition screening in older adults.
Similar content being viewed by others
References
Statistics New Zealand. National population estimates. 2018. https://www.stats.govt.nz/information-releases/national-population-estimates-at-30-june-2018. Accessed 30 June 2018
Ministry of Social Policy. The New Zealand positive ageing strategy. 2001. 1–33 p.
The Office for Seniors. Better later life He Oranga Kaumātua 2019 to 2034. 2019.
Wiles JL, Leibing A, Guberman N, Reeve J, Allen RES. The meaning of “aging in place” to older people. Gerontologist. 2012;52(3):357–66.
Office for Senior Citizens. 2014 Report on the Positive Ageing Strategy. 2014. 39 p.
Keeling S. Ageing in (a New Zealand) place: ethnography, policy and practice. Soc Policy J New Zeal. 1999;13:95–144.
Reichstadt J, Sengupta G, Depp CA, Palinkas LA, Jeste DV. Older adults’ perspectives on successful aging: qualitative interviews. Am J Geriatr Psychiatry. 2010;18(7):567–75.
Chewning B, Bylund CL, Shah B, Arora NK, Gueguen JA, Makoul G. Patient education and counseling patient preferences for shared decisions: a systematic review. Patient Educ Couns. 2012;86:9–18.
Takizawa C, Gemmell E, Kenworthy J, Speyer R. A systematic review of the prevalence of oropharyngeal dysphagia in stroke, Parkinson’s disease, Alzheimer’s disease, head injury, and pneumonia. Dysphagia. 2016;31(3):434–41.
Gallagher L, Naidoo P. Prescription drugs and their effects on swallowing. Dysphagia. 2009;24(2):159–66.
Zhao W-T, Yang M, Wu H-M, Yang L, Zhang X, Huang Y. Systematic review and meta-analysis of the association between sarcopenia and dysphagia. J Nutr Health Aging. 2018;22(8):1003–9.
Van Der Maarel-Wierink CD, Vanobbergen JNO, Bronkhorst EM, Schols JMGA, De Baat C. Meta-analysis of dysphagia and aspiration pneumonia in frail elders. J Dent Res. 2011;90(12):1398–404.
Bahat G, Yilmaz O, Durmazoglu S, Kilic C, Tascioglu C, Karan MA. Association between dysphagia and frailty in community dwelling older adults. J Nutr Health Aging. 2019;23(6):571–7.
Love AL, Cornwell PL, Whitehouse SL. Oropharyngeal dysphagia in an elderly post-operative hip fracture population: a prospective cohort study. Age Ageing. 2013;42(6):782–5.
Jardine M, Miles A, Allen J. Dysphagia onset in older adults during unrelated hospital admission: quantitative videofluoroscopic measures. Geriatrics. 2018;3(4):66.
Melgaard D, Rodrigo-Domingo M, Mørch M. The prevalence of oropharyngeal dysphagia in acute geriatric patients. Geriatrics. 2018;3(2):15.
Park YH, Han HR, Oh BM, Lee J, Park J, Yu SJ, et al. Prevalence and associated factors of dysphagia in nursing home residents. Geriatr Nurs (Minneap). 2013;34(3):212–7. https://doi.org/10.1016/j.gerinurse.2013.02.014.
Madhavan A, Lagorio A, Crary M, Dahl W, Carnaby G. Prevalence of and risk factors for dysphagia in the community dwelling elderly: a systematic review. J Nutr Health Aging. 2016;20(8):806–15.
Fávaro-Moreira NC, Krausch-Hofmann S, Matthys C, Vereecken C, Vanhauwaert E, Declercq A, et al. Risk factors for malnutrition in older adults: a systematic review of the literature based on longitudinal data. Adv Nutr. 2016;7(3):507–22.
Jones E, Speyer R, Kertscher B, Denman D, Swan K, Cordier R. Health-related quality of life and oropharyngeal dysphagia: a systematic review. Dysphagia. 2018;33(2):141–72.
Matsuo H, Yoshimura Y, Ishizaki N, Ueno T. Dysphagia is associated with functional decline during acute-care hospitalization of older patients. Geriatr Gerontol Int. 2017;17(10):1610–6.
Chatindiara I, Allen J, Popman A, Patel D, Richter M, Kruger M, et al. Dysphagia risk, low muscle strength and poor cognition predict malnutrition risk in older adults athospital admission. BMC Geriatr. 2018;18(1):1–8.
Lindgren S, Janzon L. Prevalence of swallowing complaints and clinical findings among 50–79-year-old men and women in an urban population. Dysphagia. 1991;6(4):187–92.
Avgerinou C, Bhanu C, Walters K, Croker H, Liljas A, Rea J, et al. Exploring the views and dietary practices of older people at risk of malnutrition and their carers: a qualitative study. Nutrients. 2019;11(6):1–15.
Knäuper B, Carrière K, Chamandy M, Xu Z, Schwarz N, Rosen NO. How aging affects self-reports. Eur J Ageing. 2016;13(2):185–93.
Belafsky PC, Mouadeb DA, Rees CJ, Pryor JC, Postma GN, Allen J, et al. Validity and reliability of the eating assessment tool (EAT-10). Ann Otol Rhinol Laryngol. 2008;117(12):919–24.
Keller HH, Goy R, Kane SL. Validity and reliability of SCREEN II (Seniors in the community: risk evaluation for eating and nutrition, Version II). Eur J Clin Nutr. 2005;59(10):1149–57.
Schindler A, Mozzanica F, Monzani A, Ceriani E, Atac M, Jukic-Peladic N, et al. Reliability and validity of the italian eating assessment tool. Ann Otol Rhinol Laryngol. 2013;122(11):717–24.
Farahat M, Mesallam TA. Validation and cultural adaptation of the Arabic version of the eating assessment tool (EAT-10). Folia Phoniatr Logop. 2016;67(5):231–7.
Möller R, Safa S, Östberg P. Validation of the Swedish translation of eating assessment tool (S-EAT-10). Acta Otolaryngol. 2016;136(7):749–53.
Nogueira DS, Ferreira PL, Reis EA, Lopes IS. Measuring outcomes for dysphagia: validity and reliability of the European Portuguese eating assessment tool (P-EAT-10). Dysphagia. 2015;30(5):511–20.
Lechien JR, Cavelier G, Thill MP, Huet K, Harmegnies B, Bousard L, et al. Validity and reliability of the French version of eating assessment tool (EAT-10). Eur Arch Oto-Rhino-Laryngol. 2019;276(6):1727–36. https://doi.org/10.1007/s00405-019-05429-1.
Demir N, Serel Arslan S, İnal Ö, Karaduman AA. Reliability and validity of the Turkish eating assessment tool (T-EAT-10). Dysphagia. 2016;31(5):644–9.
Tran TP, Nguyen LT, Kayashita J, Shimura F, Yamamoto S. Dysphagia prevalence among elderly in some Vietnamese hospitals. Asian J Diet. 2019;1(3):48–52.
Peñalva-Arigita A, Prats R, Lecha M, Sansano A, Vila L. Prevalence of dysphagia in a regional hospital setting: acute care hospital and a geriatric sociosanitary care hospital: a cross-sectional study. Clin Nutr ESPEN. 2019;33:86–90.
Sarabia-Cobo CM, Pérez V, de Lorena P, Domínguez E, Hermosilla C, Nuñez MJ, et al. The incidence and prognostic implications of dysphagia in elderly patients institutionalized: a multicenter study in Spain. Appl Nurs Res. 2016;30:e6–9.
Igarashi K, Kikutani T, Tamura F. Survey of suspected dysphagia prevalence in home-dwelling older people using the 10-item eating assessment tool (EAT-10). PLoS ONE. 2019;14(1):1–13.
Wham C, Fraser E, Buhs-Catterall J, Watkin R, Gammon C, Allen J. Malnutrition risk of older people across district health board community, hospital and residential care settings in New Zealand. Aust J Ageing. 2017;36(3):205–11.
Wham C, Redwood K, Kerse N. Validation of the nutrition screening tool “Seniors in the community: risk evaluation for eating and nutrition, version II” among octogenarians. J Nutr Health Aging. 2014;18(1):39–433.
Kertscher B, Speyer R, Fong E, Georgiou AM, Smith M. Prevalence of oropharyngeal dysphagia in the Netherlands: a telephone survey. Dysphagia. 2015;30(2):114–20.
Nishida T, Yamabe K, Ide Y, Honda S. Utility of the eating assessment tool-10 (EAT-10) in evaluating self-reported dysphagia associated with oral frailty in Japanese community-dwelling older people. J Nutr Health Aging. 2019. https://doi.org/10.1007/s12603-019-1256-0.
Adelman RD, Greene MG, Ory MG. Communication between older patients and their physicians. Clin Geriatr Med. 2000;16(1):1–24.
Lim Y, Kim C, Park H, Kwon S, Kim O, Kim H, et al. Socio-demographic factors and diet-related characteristics of community-dwelling elderly individuals with dysphagia risk in South Korea. Nutr Res Pract. 2018;12(5):406–14.
Saunders J, Smith T, Stroud M. Malnutrition and undernutrition. Medicine (Baltimore). 2010;39(1):45–50.
Corcoran C, Murphy C, Culligan EP, Walton J, Sleator RD. Malnutrition in the elderly. Sci Prog. 2019;102(2):171–80.
Boulos C, Salameh P, Barberger-Gateau P. Social isolation and risk for malnutrition among older people. Geriatr Gerontol Int. 2017;17(2):286–94.
Poulia KA, Yannakoulia M, Karageorgou D, Gamaletsou M, Panagiotakos DB, Sipsas NV, et al. Evaluation of the efficacy of six nutritional screening tools to predict malnutrition in the elderly. Clin Nutr. 2012;31(3):378–85. https://doi.org/10.1016/j.clnu.2011.11.017.
Wham C, Teh R, Moyes S, Dyall L, Kepa M, Hayman K, et al. Health and social factors associated with nutrition risk: results from life and living in advanced age: a cohort study in New Zealand (LILACS NZ). J Nutr Health Aging. 2015;19(6):637–45.
Hoogerduijn JG, Schuurmans MJ, Duijnstee MSH, De Rooij SE, Grypdonck MFH. A systematic review of predictors and screening instruments to identify older hospitalized patients at risk for functional decline. J Clin Nurs. 2006;16(1):46–57.
Heiss CJ, Goldberg L, Dzarnoski M. Registered dietitians and speech-language pathologists: an important partnership in Dysphagia management. J Am Diet Assoc. 2010. https://doi.org/10.1016/j.jada.2010.07.014.
Howells SR, Cornwell PL, Ward EC, Kuipers P. Understanding dysphagia care in the community setting. Dysphagia. 2019;34(5):681–91. https://doi.org/10.1007/s00455-018-09971-8.
Acknowledgements
A sincere thank you to the respondents for supporting our study, as well as to the community groups that circulated the weblink to our questionnaire. This study was funded by the Health Research Council of New Zealand and the HOPE Foundation.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Jardine, M., Miles, A. & Allen, J. Self-reported Swallowing and Nutrition Status in Community-Living Older Adults. Dysphagia 36, 198–206 (2021). https://doi.org/10.1007/s00455-020-10125-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00455-020-10125-y